Paolo Abitabile1, Christoph A Maurer. 1. Clinic for General, Visceral, Vascular, and Thoracic Surgery Hospital of Liestal, affiliated hospital of the University of Basel, Liestal, Switzerland.
Abstract
OBJECTIVE: We hypothesize that perfusion of an expandable radiofrequency ablation (RFA) needle with saline solution might help prevent charring and increase efficiency. SUMMARY BACKGROUND DATA: RFA has become an important adjunct to modern liver surgery. However, ablation is time-consuming and hazardous due to charring around the radiofrequency electrodes. METHODS: From June 2000 to November 2004, 159 liver tumors with a median diameter of 2.0 cm were treated with RFA, 54 tumors of them according to the manufacturer's standard protocol and 105 tumors according to the novel perfusion protocol. No randomization was applied. All patients were followed up with contrast enhanced computed tomography (CT) at regular intervals. Local recurrence was defined as radiologic and/or histologic evidence of viable tumor within or at the ablated liver area. RESULTS: Both study groups were comparable with regard to tumor characteristics, procedure related complications, and median times of follow-up (27 mo in the standard group versus 23 mo in the perfusion group). The median RFA time was significantly reduced from 18.9 min in the standard group to 8.0 min in the perfusion group. The rates of incomplete ablations were comparable in both groups (3.7% versus 2.8%). The rate of local recurrences at the RFA site was 6.9% overall, 11.1% in the standard group, and 4.8% in the perfusion group. No tumor seeding along the puncture channel was observed. CONCLUSIONS: The perfusion of an expandable RFA needle with saline solution significantly accelerates the ablation procedure of liver tumors without increase of complications and without compromising the oncosurgical result. Copyright (c) 2010 Elsevier Inc. All rights reserved.
OBJECTIVE: We hypothesize that perfusion of an expandable radiofrequency ablation (RFA) needle with saline solution might help prevent charring and increase efficiency. SUMMARY BACKGROUND DATA: RFA has become an important adjunct to modern liver surgery. However, ablation is time-consuming and hazardous due to charring around the radiofrequency electrodes. METHODS: From June 2000 to November 2004, 159 liver tumors with a median diameter of 2.0 cm were treated with RFA, 54 tumors of them according to the manufacturer's standard protocol and 105 tumors according to the novel perfusion protocol. No randomization was applied. All patients were followed up with contrast enhanced computed tomography (CT) at regular intervals. Local recurrence was defined as radiologic and/or histologic evidence of viable tumor within or at the ablated liver area. RESULTS: Both study groups were comparable with regard to tumor characteristics, procedure related complications, and median times of follow-up (27 mo in the standard group versus 23 mo in the perfusion group). The median RFA time was significantly reduced from 18.9 min in the standard group to 8.0 min in the perfusion group. The rates of incomplete ablations were comparable in both groups (3.7% versus 2.8%). The rate of local recurrences at the RFA site was 6.9% overall, 11.1% in the standard group, and 4.8% in the perfusion group. No tumor seeding along the puncture channel was observed. CONCLUSIONS: The perfusion of an expandable RFA needle with saline solution significantly accelerates the ablation procedure of liver tumors without increase of complications and without compromising the oncosurgical result. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Authors: David Sindram; Kerri A Simo; Ryan Z Swan; Sharif Razzaque; David J Niemeyer; Ramanathan M Seshadri; Erin Hanna; Iain H McKillop; David A Iannitti; John B Martinie Journal: HPB (Oxford) Date: 2014-09-17 Impact factor: 3.647
Authors: Muneeb Ahmed; Luigi Solbiati; Christopher L Brace; David J Breen; Matthew R Callstrom; J William Charboneau; Min-Hua Chen; Byung Ihn Choi; Thierry de Baère; Gerald D Dodd; Damian E Dupuy; Debra A Gervais; David Gianfelice; Alice R Gillams; Fred T Lee; Edward Leen; Riccardo Lencioni; Peter J Littrup; Tito Livraghi; David S Lu; John P McGahan; Maria Franca Meloni; Boris Nikolic; Philippe L Pereira; Ping Liang; Hyunchul Rhim; Steven C Rose; Riad Salem; Constantinos T Sofocleous; Stephen B Solomon; Michael C Soulen; Masatoshi Tanaka; Thomas J Vogl; Bradford J Wood; S Nahum Goldberg Journal: J Vasc Interv Radiol Date: 2014-10-23 Impact factor: 3.464